MedS Alliance Journal of Medicine and Medical Sciences https://nepjol.info/index.php/mjmms <p>The MedS Alliance Journal of Medicine and Medical Sciences is the official peer-reviewed journal of Centre for Clinical Research and Community Health (CC-REACH), MedSpirit Alliance Inc.</p> Centre for Clinical Research and Community Health (CC-REACH), MedSpirit Alliance Inc. en-US MedS Alliance Journal of Medicine and Medical Sciences 2795-1952 Clinico-pathological Study of Enteric Fever at Rapti Academy of Health Sciences, Ghorahi, Dang, Nepal https://nepjol.info/index.php/mjmms/article/view/47756 <p><strong>INTRODUCTION: </strong>The most typical cause of fever in developing nations is enteric fever. Because the complications are extremely severe, an early diagnosis is essential. Early diagnosis can improve the patient's chance of being cured. Thus, the objective of our study was to compare between blood culture, IgG and IgM method.</p> <p><strong>MATERIALS AND METHODS: </strong>This study was conducted among 240 clinically suspected cases of enteric fever from 17th February 2019 to 17th May 2019 at Rapti academic of health science, Dang. We have done first Blood culture was performed and IgG and IgM method were used to detect enteric fever for same sample.</p> <p><strong>RESULTS:</strong> Out of 240 patients, 112 of the 240 cases were men and 128 were women. Blood culture testing revealed 72 positive samples, or 30%, and IgG and IgM testing revealed 64 positive cases, or 26.66%, for the same cases. Therefore, our investigation demonstrated that the blood culture method is equally as successful as the IgG and IgM method.</p> <p><strong>CONCLUSIONS: </strong>The study concludes that he blood culture IgG and IgM methods are equally effective. There are not always blood culture settings accessible in developing countries like Nepal. Therefore, IgG and IgM methods are preferable. </p> Krishna Kumar Jha Dipesh Regmi Copyright (c) 2022 Krishna Kumar Jha, Dipesh Regmi https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 96 98 10.3126/mjmms.v2i3.47756 Non-communicable Diseases in Nepal: A Big Hurdle for Achieving SDGs https://nepjol.info/index.php/mjmms/article/view/47652 Kishor Adhikari Copyright (c) 2022 Kishor Adhikari https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 10.3126/mjmms.v2i3.47652 Time for South Asian Countries to Accept Life-Course Immunization Concept and Develop National Immunization Guidelines for Adult Vaccination https://nepjol.info/index.php/mjmms/article/view/47757 <p> Vaccine, a cost-effective medicine saves lives. Vaccination during childhood has been implemented worldwide through the expanded program of immunization (EPI) since 1974. It has saved million lives till 2019 globally. South Asian countries have equally benefitted from the EPI executing this strategy through their national immunization programs. The life-course immunization concept aims to extend the vaccination from birth to elderly; some counties have already started focusing on it. Adult vaccination is the process of vaccinating to peoples of 19 years and above. Most of the developed countries have their national policy guidelines on adult immunization but no such national policy for adult vaccination exists in most of the developing and underdeveloped countries including countries of South Asia. South Asian countries have to accept the concept Life-Course Immunization and develop National Adult Immunization Guidelines and vaccinate adults from vaccine preventable diseases highly prevalent in their countries. This could improve quality of human health at all stages of life.</p> Rano Mal Piryani Suneel Piryani Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 99 100 10.3126/mjmms.v2i3.47757 Knowledge, Attitude and Practice about Relining of Complete Dentures in Clinical Practice: A Survey among Nepalese Prosthodontists https://nepjol.info/index.php/mjmms/article/view/47653 <p><strong>INTRODUCTION</strong>: Relining refers to resurfacing the tissue side of a denture with new base material to improve adequate adaptation of the tissue surface of the denture base to the bearing foundation. It is a cost-effective means to prolong the service life of the denture. The objective of the study was to determine knowledge, attitude, and practice about relining of complete dentures in clinical practice among Nepalese Prosthodontists.</p> <p><strong>MATERIALS AND METHODS:</strong> A questionnaire-based survey was conducted among Nepalese Prosthodontists practicing in Nepal from June, 2021 to August, 2021. A pre-tested questionnaire from a published study was used for the study. A comprehensive, self-administered questionnaire consisting of close-ended questions was mailed to the participants. Data was analyzed using SPSS Ver. 17. Descriptive statistics using frequency distribution and percentage was calculated.</p> <p><strong>RESULTS</strong>: Majority 78% knew that relining is the process used to resurface the tissue side of the removable dental prosthesis with new base. 90.2% of respondents knew that relining is indicated when the residual ridges have resorbed and adaptation of the dentures to the ridges is poor. 70.7% of the participants preferred both direct and indirect technique for relining depending upon the cases. 90.2% of the respondents believed that the denture should be disinfected before relining, 9.7% disagreed that disinfection needs to be done before relining. 90.2% of the respondents felt that relining improves the stability and retention of the denture. All the prosthodontists agree that relining the denture improves the patient satisfaction.</p> <p><strong>CONCLUSIONS</strong>: Nepalese Prosthodontists had adequate knowledge regarding indication, and techniques for relining of complete dentures. Regular clinical meets and continuing dental education programs may be helpful in apprising recent development in this field.</p> Amar Bhochhibhoya Rinu Sharma Suvit Maskey Manjeev Guragain Rejina Shrestha Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 1 5 10.3126/mjmms.v2i3.47653 Adherence to Anti-tubercular Agents in DOTS Center in Western Nepal https://nepjol.info/index.php/mjmms/article/view/47654 <p><strong>INTRODUCTION: </strong>Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis and is one of the major public health problems in developing countries like Nepal. Despite the availability of effective tuberculosis treatment regimens, patients must take a combination of anti-tubercular drugs for at least six months and may endure numerous side effects, making treatment compliance exceedingly difficult to maintain. The primary objective of the study was to assess the adherence rate to anti-tubercular agents and to find the prevalence of adverse drug reactions to the anti-tubercular therapy.</p> <p><strong>MATERIALS </strong><strong>AND METHODS: </strong>This study was an observational study conducted in the DOTS centers of UCMS-TH, Bhairahawa, and Lumbini Provincial Hospital Butwal. A semi-structured questionnaire was used to collect data from 170 participants to determine the adherence rate to anti-tubercular therapy and the incidence of associated adverse drug reactions. Statistical Package for Social Sciences (SPSS Version 20) program was used to enter and analyze the data. The association between adherence and other variables was established using the Chisquare test.</p> <p><strong>RESULTS: </strong>The adherence rate to anti-tubercular therapy was found to be 159 (93.5%). The major reasons for non-adherence include forgetfulness 8 (72.72%) followed by adverse effects 2 (18.18%) and transport difficulty in reaching the health facility 1 (9.1%). The prevalence of adverse drug reactions was 58 (34.12%) (27.1 - 41.2 at 95% Confidence Interval). Adherence was significantly associated with the experience of adverse effects, literacy, marital status, area of residence, and age of the participants.</p> <p><strong>CONCLUSIONS: </strong>The adherence rate to anti-tubercular therapy was very high, which can be the primary determinant of tuberculosis treatment success.</p> Anjan Palikhey Dil Kapoor Kohar Amit Kumar Shrivastava Jharana Shrestha Laxmi Shrestha Chandrajeet Kumar Yadav Jyoti Priyanka Lokeshwar Chaurasia Dipendra Chaudhary Copyright (c) 2022 Anjan Palikhey, Dil Kapoor Kohar, Amit Kumar Shrivastava, Jharana Shrestha, Laxmi Shrestha, Chandrajeet Kumar Yadav, Jyoti Priyanka, Lokeshwar Chaurasia, Dipendra Chaudhary https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 6 11 10.3126/mjmms.v2i3.47654 Acceptability and Feasibility of Community Management of Ear Patients through Tele-otology Services in Outskirts of Kathmandu Valley, Nepal https://nepjol.info/index.php/mjmms/article/view/47655 <p><strong>INTRODUCTION:</strong> Tele-otology is one of the least explored areas of telehealth in Nepal. The objective image findings and live virtual specialist consultation using synchronous data exchange can address the different barriers to basic otological care in low-resource settings like Nepal. This study was conducted to explore the acceptability and feasibility of community management of ear patients through tele-otology.</p> <p><strong>MATERIALS AND METHODS:</strong> It was a cross-sectional descriptive study conducted at a tertiary level ENT hospital in Bhaktapur and three outreach clinics of the hospital in the periphery of Kathmandu valley from 1st April to 31st May 2021. Trained community ear health workers (CEHWs) used mobile data in fields and communicated with ENT consultants at the base hospital with fiber-to-the-home internet connection for teleconsultation. The satisfaction was measured using a 5-point Likert scale.</p> <p><strong>RESULTS:</strong> This study has shown satisfactory acceptance among beneficiaries and service providers. The sound quality rating was 4.5±0.8 at field-site and 4.5±0.9 at base hospital. The video quality ratings were 4.4±0.8 and 4.0±1.1 at field-site and base hospital, respectively; this difference was statistically significant (p=0.017).</p> <p><strong>CONCLUSIONS:</strong> With trained grassroots level workers and quality internet connections, tele-otology can play a significant role in the early identification and diagnosis of ear diseases, including middle ear pathologies, as well as bridging the ear care service gap in resource constraints settings like Nepal.</p> Luna Mathema Rajan Shrestha Arun Adhikari Prasanta Poudyal Sanjib Kumar Upadhyay Bijay Khatri Copyright (c) 2022 Luna Mathema, Rajan Shrestha, Arun Adhikari, Prasanta Poudyal, Sanjib Kumar Upadhyay, Bijay Khatri https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 12 17 10.3126/mjmms.v2i3.47655 Knowledge, Attitude and Practice on Regenerative Endodontics among Endodontists of Nepal https://nepjol.info/index.php/mjmms/article/view/47656 <p><strong>INTRODUCTION:</strong> Regenerative Endodontics is one of the most fascinating development in modern dentistry. Since Endodontists are the first providers of this type of dental treatment, it is essential to learn their knowledge, attitude and practice of these procedures. Aim: This online questionnaire-based study was conducted amongst Endodontists practicing in Nepal with the aim to learn their knowledge, attitude and practice of regenerative endodontic procedures.</p> <p><strong>MATERIALS AND METHODS:</strong> A cross-sectional study was conducted among Endodontists in Nepal. In total 65 Endodontists participated in this study. The questionnaire was distributed to the participants using the available electronic measures. Descriptive statistical analyses were performed on the responses given by Endodontists using SPSS Statistical Software package (version 21.0).</p> <p><strong>RESULTS:</strong> A total of 20 questions were included in this study. Out of the responses analyzed, 100% (n=65) had come across the term regenerative endodontics. Respondents had good knowledge about the sources of dental stem cells (87.3%, n=55). A high percentage (98.4%, n=62) of respondents strongly recommended regenerative therapy to be incorporated into dentistry. Among the participants of this study, 87.1% (n=54) had a belief that regenerative endodontic treatment could serve as the alternative treatment option to dental implant.</p> <p><strong>CONCLUSIONS:</strong> The Endodontists practicing in Nepal had sound knowledge about regenerative endodontic procedures. They were enthusiastic in practicing regenerative endodontics and interested in stem cell therapy. It’s a high time to uplift the regenerative endodontic procedure from simple revascularization via blood clotting to more advanced procedure.</p> Bhawana Adhikari Sanjeeb Chaudhary Bibek Khanal Nisha Acharya Jwolan Khadka Copyright (c) 2022 Bhawana Adhikari, Sanjeeb Chaudhary, Bibek Khanal, Nisha Acharya, Jwolan Khadka https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 18 23 10.3126/mjmms.v2i3.47656 Prevalence of Gestational Diabetes Mellitus among Pregnant Women Undergoing Oral Glucose Tolerance Test (OGTT) at Chitwan Medical College and Teaching Hospital https://nepjol.info/index.php/mjmms/article/view/47657 <p><strong>INTRODUCTION:</strong> Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance of variable severity in which spontaneous hyperglycemia develops during pregnancy. GDM is affecting approximately 14% of pregnancies worldwide, representing approximately 18 million births annually. GDM increases the risk of adverse maternal and perinatal outcome and also increases risk of future diabetes to the mother and their child.</p> <p><strong>MATERIALS AND METHODS:</strong> The cross-sectional study was carried out over 8 months in 149 pregnant subjects of gestation period between 24 and 28 at Chitwan Medical College Teaching Hospital (CMCTH). All pregnant women were considered for 50gm Glucose Tolerance Test (GCT). Those pregnant subjects with GCT ≥ 140mg% only undergo 100 gm Oral Glucose Tolerance Test (OGTT) &amp; plasma glucose were estimated at the interval of 0,1,2 and 3 hours respectively. The GDM was diagnosed after performing OGTT based on Carpenter-Coustan Criteria.</p> <p><strong>RESULTS:</strong> In our study from 149 study population, the frequency of normal &amp; abnormal GCT in pregnant women was 111(74.50%) &amp; 38(25.50%) respectively. Out of 149 subjects only 38 pregnant women have abnormal GCT in which only 23 have done OGTT test. Among 23 subjects the presence of GDM was found in 9 subjects with 39.10% whereas GDM was not found in 14 subjects with 60.9%. The prevalence of GDM among 149 populations was found to be 9 which is 6.04%.</p> <p><strong>CONCLUSIONS:</strong> The prevalence of GDM among 149 populations was found to be 6.04%. The real burden, risk factors, and potential preventative interventions of gestational diabetes mellitus must also be measured in large observational studies for finding the correlation to assess the severity of the disease.</p> Deepak Kafle Bijaya Kumar Gupta Santosh Timalsina Fuleshwar Mandal Copyright (c) 2022 Deepak Kafle, Bijaya Kumar Gupta, Santosh Timalsina, Fuleshwar Mandal https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 24 27 10.3126/mjmms.v2i3.47657 Academic Burnout among Students studying in Selected Secondary School of Chitwan https://nepjol.info/index.php/mjmms/article/view/47658 <p><strong>INTRODUCTION:</strong> Academic burnout has been widely reported in recent decades in different countries among students. Today’s students are facing dual stress in their academic endeavor i.e., higher academic expectations and perceived pressure from their parents. The aim of the study is to assess the level of academic burnout among the plus two students.</p> <p><strong>MATERIAL AND METHODS:</strong> A cross-sectional study was done among secondary level students in a school of Bharatpur municipality. The study was conducted during October 2021 and December 2021among plus two level students. A self-administered questionnaire was used for data collection. Burnout was measured by using a 25 items tool comprising different types of burnout. Descriptive and inferential statistics were computed at 5% level of significant.</p> <p><strong>RESULTS:</strong> Of total; 62.2% and 7.4% students had mild and moderate burnout respectively. Median value of total burnout was 56 out of the maximum value 125. There was strong significant correlation between personal and study related burnout, moderate significant correlation between personal and classmate related, and between personal and instructor related burn out. There was significance difference in the median personal burn out and instructor related burnout level among male and female students.</p> <p><strong>CONCLUSIONS:</strong> High academic burnout was found among secondary level students. Intervention is required to address the burden.</p> Amrita Ghimire Kishor Adhikari Ramesh Subba Bimala Sharma Sarita Nepal Taniya Thapa Copyright (c) 2022 Amrita Ghimire, Kishor Adhikari, Ramesh Subba, Bimala Sharma, Sarita Nepal, Taniya Thapa https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 28 32 10.3126/mjmms.v2i3.47658 Self-Perception, Knowledge and Awareness of Halitosis among Students of Higher Learning Institutions of Chitwan https://nepjol.info/index.php/mjmms/article/view/47659 <p><strong>INTRODUCTION:</strong> Halitosis is production of offensive odour coming out from oral cavity which most people try to avoid. It also leads to anxiety and social embarrassment. The people having halitosis have compromised quality of life. Hence this study was planned to assess the self-perception, knowledge and awareness of halitosis among students of higher learning institutions of Chitwan.</p> <p><strong>MATERIALS AND METHODS:</strong> This was a descriptive cross-sectional study conducted among 280 students of higher secondary schools and colleges of Chitwan. The data collection was done from August 2021 to October 2021. A self-administered questionnaire was used. The results obtained were entered into Microsoft Excel 2019 and then transferred into Statistical Package for Social Science (SPSS) version 16. Descriptive statistical analysis was done. The study was analysed using frequency, percentages, mean and standard deviation.</p> <p><strong>RESULTS:</strong> In this study, the mean age of the participants was 23.75 years. More than 90% of the participants belonged to 20-29 age group. Among the participants 44.3% reported of bad breath, while only 15.4% visited doctor and received treatment. Around 41.1% believed oral check-up as common diagnostic measures for halitosis and 40.4% had an opinion of consulting dentist for bad breath. The bad breath affected their social life behaviour, ended up friendship, stayed separate and away from friends and family. Around 64.5% were isolated from society.</p> <p><strong>CONCLUSIONS:</strong> From our study we can conclude that halitosis is common problem in developing and developed nation. In the present study self-reported halitosis was present. The proper oral hygiene methods were lagging. Proper need of oral hygiene education and awareness campaign is therefore necessary.</p> Saroj Balami Erika Shrestha Arun Dhungana Ayam Chhatkuli Manish Shrestha Rajib Chaulagain Copyright (c) 2022 Saroj Balami, Erika Shrestha, Arun Dhungana, Ayam Chhatkuli, Manish Shrestha, Rajib Chaulagain https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 33 38 10.3126/mjmms.v2i3.47659 Use of Family Planning Methods among Postpartum Mothers in Bharatpur Metropolitan City https://nepjol.info/index.php/mjmms/article/view/47705 <p><strong>INTRODUCTION: </strong>Low utilization of modern contraceptives immediately after birth remains low in Nepal. Hence the Government of Nepal has given significant importance on postpartum family planning to address the unmet need of family planning in Nepal. The aim of the present study was to assess the prevalence of postpartum family planning Utilization among women and its associated factors.</p> <p><strong>MATERIALS AND METHODS: </strong>A descriptive, cross- sectional, study was conducted among 133 mothers who had one year of children. The data collection tool was a semi structured interview schedule. Data were entered using Epi data 3.1 software and analyzed using SPSS 16. The statistical analyses carried out were descriptive (frequencies and percentages) and bivariate (chi-square test).</p> <p><strong>RESULTS: </strong>The current utilization of family planning methods was 23.3% and utilization of family planning in the past year was 28.6%. The Depo -Provera (38.7%) is the most commonly used family planning method among respondents. About half of the respondents (45.9%) did not get family planning counselling during ANC Visit. Husband Occupation (p-value =0.004), family planning counselling during ANC Visit (p-value =0.017), Knowledge on appropriate birth space (p-value =0.017) and IUCD use (p-value=0.042).</p> <p><strong>CONCLUSIONS: </strong>Contraceptive utilization among postpartum mothers was found to be extremely low which ultimately increases health risk to maternal health due to chances of unintended pregnancies. </p> Susila Pokharel Gayatri Khanal Sakuntala Chapagain Kishor Adhikari Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 39 43 10.3126/mjmms.v2i3.47705 Antibiotic Resistance among Gram Negative Bacilli Isolated from the ICU Admitted Patients Attending Chitwan Medical College Teaching Hospital https://nepjol.info/index.php/mjmms/article/view/47748 <p><strong>INTRODUCTION: </strong>Antimicrobial therapy is the main stone in treatment. Gram negative bacilli are common cause of sepsis, pneumonia and urinary tract infections in ICU patients. Their treatment becomes more challenging due to the evolution of multiple drug resistant strains. The findings of this study would be useful in the formation of effective diagnostic approaches and policy of antimicrobial therapy for the treatment of infections in a similar intensive care hospital setting.</p> <p><strong>MATERIALS AND METHODS: </strong>A Laboratory based descriptive cross-sectional study was conducted at the department of clinical microbiology of the Chitwan Medical College Teaching Hospital based on the reports of 129 bacterial isolated of various clinical specimens from different ICUs of hospital between April 2018 to September 2018.</p> <p><strong>RESULTS: </strong>Among the 129-gram bacilli isolated mono bacterial growth were 116(89.92%) while remaining 13(10.08%) had poly bacterial or mixed organisms isolated. The most frequently isolated organisms were <em>Acinetobacter spp. </em>51(39.55%), <em>Escherichia coli </em>25(19.37%), <em>Klebsiella spp. </em>27(20.93%), <em>Pseudomonas aeruginosa </em>17(13.95%) and <em>Enterobacter spp. </em>8(6.2%). Antibiotic resistance was observed in many organisms with multidrug resistance 97(75.2%) among them. High level of resistance was observed to Cefotaxime (98.04%), Ceftriaxone (96.08%), Imipenem (80.39%), Ampicillin/sulbactam (72.55%) and Amikacin (70.59%). Ciprofloxacin (68.63%), Levofloxacin (27.45%) and Meropenem (28.21%) were found to be relatively effective against <em>Acinetobacter spp. </em>Isolated.</p> <p><strong>CONCLUSIONS: </strong>Most of the frequently isolated organisms are multi drug resistant. </p> Soni Koju Navin Kumar Chaudhary Shital Adhikari Kishor Adhikari Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 44 49 10.3126/mjmms.v2i3.47748 Assertiveness and Self-esteem among Nurses Working at a Teaching Hospital, Bharatpur, Chitwan https://nepjol.info/index.php/mjmms/article/view/47749 <p><strong>INTRODUCTION: </strong>In the nursing profession, assertiveness and self-esteem are essential components for effective patient care and therapeutic relationships. Lack of these components have been found to be a major problem in the nursing profession today. The objective of the study was to find out the level of assertiveness and self-esteem among nurses working at Teaching Hospital, Bharatpur, Chitwan.</p> <p><strong>MATERIALS AND METHODS: </strong>A descriptive cross-sectional study design was conducted among 155 nurses working at Chitwan Medical College, Teaching Hospital, Bharatpur, Chitwan. Stratified proportionate simple random sampling technique was used to select sample. Data was collected by using standardized self-administered tool {Simple Rathus Assertiveness Schedule (SRAS) and Rosenberg Self-esteem Scale (RSES)} from 2078-11-29 to 2078-12-11. Data were analyzed by using descriptive and inferential statistics.</p> <p><strong>RESULTS: </strong>The study revealed that more than half of the nurses (51.0%) have high assertiveness and more than half of the nurses (54.8%) have high level of self-esteem. There was statistically significant association between assertiveness and age (p=0.004), ethnicity (p&lt;0.001), area of residence (p=0.020), marital status (p=0.008), educational level (p=0.001) and work experiences (p=0.044) of the nurses. Similarly, there was statistically significant association between self-esteem and age (p=&lt;0.001), educational level (p=0.010) and self-reported job satisfaction (p=&lt;0.001).</p> <p><strong>CONCLUSIONS: </strong>In conclusion, about half of the nurses have low level of assertiveness and low level of self-esteem. Thus, the organization need to plan and conduct different training programs on improving assertiveness and self-esteem for the nurses so that it will boost their confidence, and this will ultimately improve patient care. </p> Urica Sharma Marahatta Dipti Koirala Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 50 56 10.3126/mjmms.v2i3.47749 Moral Distress among Nurses Working in a Teaching Hospital https://nepjol.info/index.php/mjmms/article/view/47750 <p><strong>INTRODUCTION: </strong>Distress is a serious problem to nurses, the deepest source of distress that nurse’s experience has been arisen because of the variation between nurse’s values and reality of daily nursing practice. Moral distress referred to the cognitive-emotional dissonance that arises when one feels compelled to act against one’s moral requirements. Moral distress has a deleterious effect on patients, nurses, and organizations which results in decreased job satisfaction, increased turnover, and withdrawal from a job, and developing physical and psychological symptoms. The aim of this study is to assess the moral distress among the nurses in Chitwan Medical College Teaching Hospital.</p> <p><strong>MATERIALS AND METHODS: </strong>A descriptive, cross-sectional research design was conducted among 114 nurses of Chitwan Medical College Teaching Hospital by use probability, stratified random sampling technique. Data was collected by using Standard Hamric Modified Distress Scale-Revised (MDS-R).</p> <p><strong>RESULTS: </strong>The study finding revealed that majority of nurses (82.5%) had mild moral distress and 17.5% had severe moral distress. The father’s occupation was significantly associated with moral distress (p=0.035). Interestingly, a statically significant association was observed between moral distress and respondents who were utilizing facilities of government health insurance (p=0.013).</p> <p><strong>CONCLUSIONS: </strong>Nearly one fifth of the nurses have severe moral distress which is less in count but its effects may be severe. Hence special program needs to be organized by hospital admission for nurses to minimize the moral distress. </p> Amita Ale Ramesh Subba Amrita Ghimire Sarita Nepal Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 57 62 10.3126/mjmms.v2i3.47750 Assessment of Self-care practices, Treatment satisfaction and Quality of Life among Diabetes Type2 Patients in Pokhara, Nepal https://nepjol.info/index.php/mjmms/article/view/47751 <p><strong>INTRODUCTION: </strong>Treatment satisfaction and health-related quality of life are related and important for successful treatment of diabetes patients. The main objective of this research is to assess the self-care practices, treatment satisfaction and quality of life among diabetes type2 patient in Pokhara.</p> <p><strong>MATERIALS AND METHODS: </strong>A cross-sectional study was conducted among the diabetes type2 patients from June 2019 to December 2019 in Pokhara Metropolitan. The sample size for this study was 248. Consecutive sampling technique was used for the selection of participants. Interview schedule was used for doing face to face interview. A collection of questions adapted from Diabetes-39 and it was used as a tool for assessing the quality of life of the participants. The Nepali version of the D-39 instrument was pre-tested among 10% (25) of total sample in Metrocity hospital to check its simplicity before data collection. Likert scale of 5 points was used to assess treatment satisfaction. Chi-square test was obtained to find out the association between dependent and independent variables and crude odd ratio was calculated to measure the strength of association.</p> <p><strong>RESULTS: </strong>Two-fourth (41.9%) of the participants were engaged in physical activity. Two-fifth (39.9%) of the participants test blood sugar monthly. About four-sixth (68.5%) of the participants had good quality of life and rest had poor quality of life. Almost all 98.0% were satisfied with the treatment. Factors such as age, sex, marital status, physical activity and duration of diabetes mellitus were associated with quality of life.</p> <p><strong>CONCLUSIONS: </strong>The study showed that physical activities should be focused to promote healthier life. One should focus on promoting a self-care practices in order to prevent the complication of disease. Quality of life can be achieved through adequate self-care practice, proper treatment and counselling.</p> Pragya Banstola Dipendra Kumar Yadav Raju Pandey Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 63 69 10.3126/mjmms.v2i3.47751 Exemplification of ABO Blood Groups in Patients with Diabetes Mellitus https://nepjol.info/index.php/mjmms/article/view/47752 <p><strong>INTRODUCTION: </strong>Diabetes Mellitus and blood groups are interrelated. The relationship between ABO blood groups and disease susceptibility has generated a concern. The identification of a positive relationship between DM and blood groups could indicate higher susceptibility to diabetes and a negative relationship could indicate protection from diabetes. Therefore, the objective of the study was designed to exemplify ABO blood groups in Patients with Diabetes Mellitus.</p> <p><strong>MATERIALS AND METHODS: </strong>The study was conducted at Ram Janaki Hospital and Swastika Health Care Hospital, Janakpurdham from September 2017 to March 2018.The record of the patients from the medicine OPD in both the hospitals was identified and relevant data were extracted. The data was recorded from the reports of the patients with confirmed DM patients attending Medicine department.</p> <p><strong>RESULTS: </strong>The majority of the 579 diabetic patients were in the 40-60 year old age group. The most predominant blood group was B (251; 43.4 %), followed by AB (137; 23.7 %), O (125; 21.5 %), and A (66; 11.4 %) respectively. In comparison to male diabetics, less than half (44.1%) of female diabetics had blood group B. (42.7%). Similarly, males (13.0 %) were found to have more blood group A than females (9.8%). In diabetic individuals, the relationship between blood group and age (p=0.652) and sex (p=0.659) was shown to be insignificant. The majority of the patients (94.3%) had Rh positive blood groups, whereas the other had Rh negative blood types (5.7%). There was no correlation between blood group Rh factor and age group (p=0.817) or as well as with sex (p=0.333) among diabetic patients.</p> <p><strong>CONCLUSIONS: </strong>Diabetic patients were more likely to have blood type B, while diabetics were less likely to have blood group A. It implies that diabetes is linked to ABO blood types, and that those with Group-B are more likely to develop the condition. Blood group could be a risk factor, and knowing it can aid with disease evaluation and screening.</p> Satyam Prakash Khushbu Yadav Vijay Kumar Sah Dipendra Raj Pandeya Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 70 75 10.3126/mjmms.v2i3.47752 Health Related Quality of Life among Reproductive Age Women Having Polycystic Ovarian Syndrome https://nepjol.info/index.php/mjmms/article/view/47753 <p><strong>INTRODUCTION: </strong>Polycystic ovarian syndrome (PCOS) is a common endocrine disorder commonly seen in young reproductive age women and is manifested by polycystic appearing ovaries on ultrasonography along with oligomenorrhoea or amenorrhoea, hirsutism, obesity and emotional disturbances further leading to infertility and metabolic disturbances as well as chronic illness. These symptoms, however, are frequently linked to decline woman's self-esteem and self-image, and may have an impact on her health-related quality of life (HRQoL).</p> <p><strong>MATERIALS AND METHODS: </strong>Descriptive, web based-cross sectional study was conducted among 686 reproductive age women of Facebook page named PCOS WARRIOR Nepali woman selected conveniently. Structured and standardized health related quality of life questionnaire (German PCOS Questionnaire -g) was used to collect data by posting google form on Facebook page. Obtained data were analysed in Statistical Package for Social Science (SPSS) version 20, descriptive statistics and inferential statistics.</p> <p><strong>RESULTS: </strong>More than half (50.9%) of the respondents were found to have good quality of life. The most common health related concern was for Infertility (28.57%) and least was for Acne (71.43%). There was statistically significance between Health-related quality of life and Body Mass Index (BMI) (p=&lt;0.001), menstruation Pattern (p=0.013), duration of medication (p=0.002) and presence of co-morbidities (p=0.010) respectively.</p> <p><strong>CONCLUSIONS: </strong>It is concluded that more than half of the respondents have good quality of life. Various programmes should be conducted regarding infertility and assisted reproductive technologies giving special attention to the women having PCOS. Management of PCOS should be directed to improve quality of life of PCOS patients.</p> Manisha Aryal Taniya Thapa Amrita Ghimire Sadikshya Neupane Sarita Nepal Alisha Joshi Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 76 82 10.3126/mjmms.v2i3.47753 Menstruation Hygiene Management among Adolescent School Girls of Inaruwa Municipality https://nepjol.info/index.php/mjmms/article/view/47754 <p><strong>INTRODUCTION</strong>: Menstrual Hygiene Management (MHM) for girls has long been a neglected issue in low income countries however there is increasing recognition that it should be included in research, programming, education and health policies. The aim of the study was to assess the menstrual hygiene management among adolescent school girls residing Inaruwa Municipality of Sunsari district.</p> <p><strong>MATERIALS AND METHODS: </strong>A descriptive cross-sectional study design was conducted on 211 respondents and self-administered questionnaire used as data collection tool. Epi-data version 3.1 and SPSS version IBM 22 was used for data entry and analysis software respectively</p> <p><strong>RESULTS: </strong>Majority 74.4% had their first menstruation at the age between 13-15years. In the first menstrual period, the girls were frightened (40.3%) and confused (36%). Entire girls revealed that they were using any type of absorptive materials during menstrual period. Nearly three-fifth of the girls (55.5%) only used sanitary napkin/pad as a protective material during menstruation and 14.2 percent of the girls were using old piece of cloth. Half of the girls (50.9%) used to change their absorptive materials twice a day and 32.5 percent of them changed thirst a day during their menstrual period. After the used of absorptive material, nearly two-third of the girls reported that they used to bury absorptive materials in separate place secretly, while 37.3 percent of girls reported that they used to burn.</p> <p><strong>CONCLUSIONS: </strong>The menstrual hygiene practices at home seem to be satisfactory. However, in school, the insufficient toilets, dustbins were the reasons for making the menstruation hygiene difficult and impossible during the school hours. This lead to missing of classes, and school absenteeism during the periods.</p> Ram Bahadur Shrestha Apeksha Bhatta Copyright (c) 2022 https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 83 88 10.3126/mjmms.v2i3.47754 Knowledge Regarding Attention Deficit Hyperactivity Disorder among School Teachers in a Secondary School https://nepjol.info/index.php/mjmms/article/view/47755 <p><strong>INTRODUCTION: </strong>Attention deficit hyperactivity disorder (ADHD) is one of the most common behaviours and emotional problem arises in school age children. Teachers can play a key role in identifying and supporting students with this disorder. In order to achieve this role, it is vital for teachers to have obvious knowledge about this disorder. The aim of this study was to assess knowledge regarding Attention deficit hyperactivity disorder among school teachers.</p> <p><strong>MATERIALS AND METHODS: </strong>Descriptive study method was used; altogether 70 samples from Prabhat secondary school teachers were selected by using of census sampling technique. Most of them recognized attention deficit hyperactivity disorder was behavior and emotional problem which was arise in school age period. Similarly, Maximum response about symptoms were forgetfulness and difficulty engaging in non-action activities. Maximum respondents had answered for management way of Attention deficit hyperactivity disorder was motivational therapy.</p> <p><strong>RESULTS: </strong>The findings of the study revealed that majority 88.3 % of the respondents had poor knowledge and 11.7% had moderate knowledge regarding attention deficit hyperactivity disorder. The study also showed that the variables such as age, sex, marital status, educational level and teaching experience were not significantly related to knowledge on attention deficit hyperactivity disorder.</p> <p><strong>CONCLUSIONS: </strong>This study concluded that the majority of respondent had poor knowledge about Attention deficit hyperactivity disorder. Variables such as age, sex, marital status, educational level and teaching experience were not significantly related to knowledge on attention deficit hyperactivity disorder.</p> Sumitra Nakarmi Sona Bhandari Copyright (c) 2022 Sumitra Nakarmi, Sona Bhandari https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 89 95 10.3126/mjmms.v2i3.47755 Madhesh Institute of Health Sciences (MIHS): 1st Anniversary https://nepjol.info/index.php/mjmms/article/view/47758 Khushbu Yadav Copyright (c) 2022 Khushbu Yadav https://creativecommons.org/licenses/by-nc/4.0 2022-08-20 2022-08-20 2 3 101 102 10.3126/mjmms.v2i3.47758